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HIV and hepatitis C mortality in Massachusetts, 2002-2011: spatial cluster and trend analysis of HIV and HCV using multiple cause of death.

Meyers DJ, Hood ME, Stopka TJ - PLoS ONE (2014)

Bottom Line: The most significant clusters occurred in Springfield, Worcester, South Boston, the Merrimack Valley, and New Bedford with other smaller clusters detected across the state.Multiple cause of death mortality rates were much higher than underlying cause mortality alone, and significant disparities existed across race and age groups.We found that our multi-method analyses, which focused on contributing causes of death, were more robust than analyses that focused on underlying cause of death alone.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, United States of America; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America.

ABSTRACT

Background: Infectious diseases, while associated with a much smaller proportion of deaths than they were 50 years ago, still play a significant role in mortality across the state of Massachusetts. Most analysis of infectious disease mortality in the state only take into account the underlying cause of death, rather than contributing causes of death, which may not capture the full extent of mortality trends for infectious diseases such as HIV and the Hepatitis C virus (HCV).

Methods: In this study we sought to evaluate current trends in infectious disease mortality across the state using a multiple cause of death methodology. We performed a mortality trend analysis, identified spatial clusters of disease using a 5-step geoprocessing approach and examined spatial-temporal clustering trends in infectious disease mortality in Massachusetts from 2002-2011, with a focus on HIV/AIDS and HCV.

Results: Significant clusters of high infectious disease mortality in space and time throughout the state were detected through both spatial and space time cluster analysis. The most significant clusters occurred in Springfield, Worcester, South Boston, the Merrimack Valley, and New Bedford with other smaller clusters detected across the state. Multiple cause of death mortality rates were much higher than underlying cause mortality alone, and significant disparities existed across race and age groups.

Conclusions: We found that our multi-method analyses, which focused on contributing causes of death, were more robust than analyses that focused on underlying cause of death alone. Our results may be used to inform public health resource allocation for infectious disease prevention and treatment programs, provide novel insight into the current state of infectious disease mortality throughout the state, and benefited from approaches that may more accurately document mortality trends.

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Related in: MedlinePlus

Statistically significant hotspots and coldspot clusters of HCV in Massachusetts census tracts between 2002–2011.A Getis Ord GI* test was run as specified in the five-step geoprocessing approach. Red areas represent statistically significant hotspots of all-cause HCV mortality. Blue areas represent statistically significant coldspots. Darker colors represent higher levels of significance. Shapefiles were provided by MassGIS, death data were provided by the Massachusetts Department of Public Health, and population estimates were provided by the US Census Bureau. NAD 1983 Massachusetts State Plain was used for projection. Maps created in ArcGIS 10.2.
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pone-0114822-g008: Statistically significant hotspots and coldspot clusters of HCV in Massachusetts census tracts between 2002–2011.A Getis Ord GI* test was run as specified in the five-step geoprocessing approach. Red areas represent statistically significant hotspots of all-cause HCV mortality. Blue areas represent statistically significant coldspots. Darker colors represent higher levels of significance. Shapefiles were provided by MassGIS, death data were provided by the Massachusetts Department of Public Health, and population estimates were provided by the US Census Bureau. NAD 1983 Massachusetts State Plain was used for projection. Maps created in ArcGIS 10.2.

Mentions: The five-step geoprocessing approach was carried out for each disease of interest to identify hotspot clusters. From the original 1,471 census tracts, 1,373 were taken after removing those 1.5 standard deviations larger than the mean area and any remaining island census tracts. The average distance between census tracts was calculated to be 2,244 meters and the maximum distance was calculated to be 9,361 meters. After running incremental spatial autocorrelations for HIV/AIDS and HCV, HIV's ideal spatial scale was identified to be 12,000 meters while HCVs was identified to be 7,200 meters. These numbers were used to generate spatial weights matrices that were used to weight the final Getis-Ord Gi* analysis. Fig. 8 depicts the final hotspot analysis results for HCV and Fig. 9 highlights the final hotspot analysis results for HIV/AIDS.


HIV and hepatitis C mortality in Massachusetts, 2002-2011: spatial cluster and trend analysis of HIV and HCV using multiple cause of death.

Meyers DJ, Hood ME, Stopka TJ - PLoS ONE (2014)

Statistically significant hotspots and coldspot clusters of HCV in Massachusetts census tracts between 2002–2011.A Getis Ord GI* test was run as specified in the five-step geoprocessing approach. Red areas represent statistically significant hotspots of all-cause HCV mortality. Blue areas represent statistically significant coldspots. Darker colors represent higher levels of significance. Shapefiles were provided by MassGIS, death data were provided by the Massachusetts Department of Public Health, and population estimates were provided by the US Census Bureau. NAD 1983 Massachusetts State Plain was used for projection. Maps created in ArcGIS 10.2.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263669&req=5

pone-0114822-g008: Statistically significant hotspots and coldspot clusters of HCV in Massachusetts census tracts between 2002–2011.A Getis Ord GI* test was run as specified in the five-step geoprocessing approach. Red areas represent statistically significant hotspots of all-cause HCV mortality. Blue areas represent statistically significant coldspots. Darker colors represent higher levels of significance. Shapefiles were provided by MassGIS, death data were provided by the Massachusetts Department of Public Health, and population estimates were provided by the US Census Bureau. NAD 1983 Massachusetts State Plain was used for projection. Maps created in ArcGIS 10.2.
Mentions: The five-step geoprocessing approach was carried out for each disease of interest to identify hotspot clusters. From the original 1,471 census tracts, 1,373 were taken after removing those 1.5 standard deviations larger than the mean area and any remaining island census tracts. The average distance between census tracts was calculated to be 2,244 meters and the maximum distance was calculated to be 9,361 meters. After running incremental spatial autocorrelations for HIV/AIDS and HCV, HIV's ideal spatial scale was identified to be 12,000 meters while HCVs was identified to be 7,200 meters. These numbers were used to generate spatial weights matrices that were used to weight the final Getis-Ord Gi* analysis. Fig. 8 depicts the final hotspot analysis results for HCV and Fig. 9 highlights the final hotspot analysis results for HIV/AIDS.

Bottom Line: The most significant clusters occurred in Springfield, Worcester, South Boston, the Merrimack Valley, and New Bedford with other smaller clusters detected across the state.Multiple cause of death mortality rates were much higher than underlying cause mortality alone, and significant disparities existed across race and age groups.We found that our multi-method analyses, which focused on contributing causes of death, were more robust than analyses that focused on underlying cause of death alone.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, United States of America; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America.

ABSTRACT

Background: Infectious diseases, while associated with a much smaller proportion of deaths than they were 50 years ago, still play a significant role in mortality across the state of Massachusetts. Most analysis of infectious disease mortality in the state only take into account the underlying cause of death, rather than contributing causes of death, which may not capture the full extent of mortality trends for infectious diseases such as HIV and the Hepatitis C virus (HCV).

Methods: In this study we sought to evaluate current trends in infectious disease mortality across the state using a multiple cause of death methodology. We performed a mortality trend analysis, identified spatial clusters of disease using a 5-step geoprocessing approach and examined spatial-temporal clustering trends in infectious disease mortality in Massachusetts from 2002-2011, with a focus on HIV/AIDS and HCV.

Results: Significant clusters of high infectious disease mortality in space and time throughout the state were detected through both spatial and space time cluster analysis. The most significant clusters occurred in Springfield, Worcester, South Boston, the Merrimack Valley, and New Bedford with other smaller clusters detected across the state. Multiple cause of death mortality rates were much higher than underlying cause mortality alone, and significant disparities existed across race and age groups.

Conclusions: We found that our multi-method analyses, which focused on contributing causes of death, were more robust than analyses that focused on underlying cause of death alone. Our results may be used to inform public health resource allocation for infectious disease prevention and treatment programs, provide novel insight into the current state of infectious disease mortality throughout the state, and benefited from approaches that may more accurately document mortality trends.

Show MeSH
Related in: MedlinePlus